Specialized Services

A B C D E F G H I K L M N O P R S T U V W Y All Services

The Transition Process

When patients with chronic childhood illness such as congenital heart disease reach adulthood, their needs change. Studies show that these patients benefit from transitioning into an adult program that's designed to meet their evolving needs.

The UCSF Adult Congenital Heart Disease (ACHD) program differs from pediatric programs in the following ways:

• Shift Focus to Physical Aging — Adults are physically aging in contrast to young children who are physically growing and developing.



• Address Adult Medical Issues — Adults with chronic childhood illness often develop medical issues that are different than pediatric chronic issues such as the management of diabetes, renal disease, systemic hypertension, liver disease and psychiatric illness. Even heart failure and arrhythmias are different in the adult compared to the pediatric patient.



• Change in Visit Dynamics — The office visits evolve into a relationship where there is direct communication between doctor and patient. This does not preclude the inclusion of family members, but the visits remain patient focused.



• Focus on Problem-Solving Strategies — As young people develop, they move from using emotional coping strategies to problem solving strategies. Chronic illness often interferes with this development and has been associated with depression and anxiety. An adult clinic focuses and recognizes the importance of developing these strategies.



• Focus on Patient Education —

Promote the understanding of the major cardiovascular issues:

• Basic anatomy and physiology of the patient's congenital heart disease and surgical repair
• Potential problems a patient may face in the future with an emphasis on the importance of follow-up, adherence to medical care and prevention
• Important signs and symptoms about which to worry about
• Reasons for medications prescribed and the potential side effects

Promote the patients understanding of the major health issues:

• Sexual health
• Substance abuse
• Exercise and nutrition
• Self-advocacy issues
• Vocational issues
• Adherence to medical care
• Peer support
• Insurability

The Transition Program at UCSF

The goals of the UCSF Transition Program are to provide uninterrupted health care that is patient centered, age and developmentally appropriate, flexible and comprehensive. The program also strives to:

• Educate patients about their disease
• Promote skills in communication, decision making, self care and self advocacy
• Promote personal and medical independence, to promote a sense of control over one's health, health care decisions and psychosocial environment
• Maximize quality of life and future potential

The transition process includes:

• The patient, parents, family and close friends
• The ACHD team including staff cardiologist and nurse practitioner
• Primary care provider and primary pediatric cardiologist
• A health care team including a key medical consult list of adult caregivers that have a special interest and sensitivity to the young adult with chronic medical illness (i.e. gynecology and obstetrics, hepatology and gastroenterology, pulmonology and endocrinology)
• A consult list of other non-medical professional services (i.e. educational, vocational and social services)

Other resources include:

• Bi-annual seminars for young teens and their parents to discuss the issues surrounding transition and transfer of care
• Peer support groups for young adults with CHD
• Educational seminars for young adults with CHD including the following topics:



• Nutrition
• Pregnancy and congenital heart disease
• New technologies and interventions
• New medications
• Insurance
• Educational and vocational opportunities

To Schedule an Appointment

To make an appointment contact the Pediatric Heart Center scheduling department at (415) 353-2008.

Clinic Location: 400 Parnassus Avenue, 2nd floor, Pediatric Heart Center

Our Experts

Dr. Alison Knauth Meadows, is an expert in caring for young adults with congenital heart disease as they transition between pediatric and adult care teams and started the Transition Program.

Valerie Bosco, a registered nurse, is a senior clinician within the UCSF Adult Congenital Heart Disease Program, with expertise in the care of patients with complex congenital cardiac disease.

Elizabeth Tong, a registered nurse, is a senior clinician within the UCSF Adult Congenital Heart Disease Program, with expertise in the care of patients with complex congenital cardiac disease.

For Referring Physicians

How to schedule a visit to the UCSF Transition Program

The UCSF Transition Program respects and values the relationships referring physicians have with their patients. UCSF's goal is to compliment this existing relationship and to provide access to specialty services along with education and research. To provide the best care for young adults with congenital heart disease and their families, UCSF's Transition Program has created clinical care guidelines that can be implemented into a referring physician's practice.

Appointments can be made through the Pediatric Heart Center scheduling department at (415) 353-2008. If you would like to speak to someone about the details of the referral, Meadows can be reached at (415) 353-2756 or by email Alison.Meadows@radiology.ucsf.edu.